“EFFECTIVENESS OF COUNSELLING INTERVENTIONS IN TOBACCO CESSATION AT A TERTIARY CARE HOSPITAL: AN ORIGINAL RESEARCH STUDY”
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Keywords
Tobacco cessation, Counselling interventions, Nicotine dependence, Motivation to quit, ) Biochemical verification, Pharmacotherapy
Abstract
Introduction: Tobacco use remains a significant global public health challenge, contributing to numerous health issues and substantial mortality. Despite widespread awareness of its risks, tobacco use persists, particularly in low- and middle-income countries. Effective cessation interventions are essential to reduce tobacco-related harm. Aim: This study evaluates the effectiveness of counselling interventions in promoting tobacco cessation among patients at a tertiary care hospital. Methods: A longitudinal study was conducted with 200 participants at the Tobacco Cessation Clinic of Noida International Institute of Medical Sciences (NIIMS). Participants received individualized counselling based on the 5 A’s model over a six-month period. Data collection included self-reported tobacco use, cigarettes smoked per day, nicotine dependence (FTND), motivation to quit (MTSS), and biochemical verification (CO levels). Statistical analyses included paired t-tests, chi-square tests, and logistic regression.
Results: At three months, the cessation rate was 42%, which decreased to 36% by six months. Participants who did not quit showed a significant reduction in cigarette consumption, from an average of 18 to 8 cigarettes per day. Motivation to quit improved significantly, with MTSS scores increasing from 3.4 to 7.1. Predictors of successful cessation included lower baseline FTND scores, higher baseline motivation, and the use of pharmacotherapy. Biochemical verification confirmed cessation in 90% of self-reported quitters.
Conclusion: Counselling interventions at the NIIMS Tobacco Cessation Clinic significantly supported tobacco cessation and reduced tobacco use. The study highlights the effectiveness of the 5 A’s model and pharmacotherapy, while also identifying predictors of successful cessation. These findings underscore the importance of tailored, multidisciplinary approaches in tobacco cessation programs and suggest further research to validate these interventions in diverse settings.
References
2. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Washington, DC: U.S. Department of Health and Human Services; 2014 [cited 2023 Jul 17]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK179276/
3. World Health Organization. WHO global report on trends in prevalence of tobacco use 2000-2025, fourth edition. Geneva: WHO; 2021.
4. World Health Organization. Global Adult Tobacco Survey (GATS) India 2016-17 Fact Sheet [Internet]. Geneva: WHO; 2017 [cited 2020 Mar 25]. Available from: https://www.who.int/tobacco/surveillance/survey/gats/GATS_India_2016-17_FactSheet.pdf
5. Lancaster T, Stead L, Silagy C. Various interventions increase smoking cessation rates. Evid Based Med. 2001;6(2).
6. Lancaster T, Stead L, Silagy C, Sowden A. Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library. BMJ. 2000;321(7257):355-8.
7. Sussman S. Effects of sixty-six adolescent tobacco use cessation trials and seventeen prospective studies of self-initiated quitting. Tob Induc Dis. 2002;1(1):35.
8. Apollonio D, Philipps R, Bero L. Interventions for tobacco use cessation in people in treatment for or recovery from substance use disorders. Cochrane Database Syst Rev. 2016;(11).
9. Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev. 2013;(5). doi: 10.1002/14651858.CD000165.pub4.
10. Hughes JR, Keely J, Naud S. Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction. 2004;99(1):29–38. doi: 10.1111/j.1360-0443.2004.00540.x.
11. Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service; 2008 May.
12. Koh-Knox CP. Motivational Interviewing in Health Care: Helping Patients Change Behavior. Am J Pharm Educ. 2009 Nov 12;73(7):127. PMCID: PMC2779641.
13. Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991;86(9):1119–27. doi: 10.1111/j.1360-0443.1991.tb01879.x.
14. West R. Theories of addiction. Addiction. 2001;96(1):3–13. doi: 10.1046/j.1360-0443.2001.96131.x.
15. Benowitz NL, Bernert JT, Caraballo RS, Holiday DB, Wang J. Optimal serum cotinine levels for distinguishing cigarette smokers and nonsmokers within different racial/ethnic groups in the United States between 1999 and 2004. Am J Epidemiol. 2009;169(2):236–48. doi: 10.1093/aje/kwn301.
16. Cahill K, Stevens S, Perera R, Lancaster T. Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev. 2013;(5). doi: 10.1002/14651858.CD009329.pub2.
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Dr. Rama Shankar
Assistant Professor Department of Community Medicine/Noida International Institute of Medical Sciences (NIIMS)/Noida International University (NIU), Greater Noida District Gautam Budh Nagar Uttar Pradesh India.
Dr. Visuja Chaudhary
Associate Professor Department of Dentistry/Noida International Institute of Medical Sciences (NIIMS)/Noida International University (NIU), Greater Noida District Gautam Budh Nagar Uttar Pradesh India.
Dr. Sachet Dawar
Associate Professor Department of Respiratory Medicine/Noida International Institute of Medical Sciences (NIIMS)/Noida International University (NIU), Greater Noida District Gautam Budh Nagar Uttar Pradesh India.
Dr. Manvi Srivastava
Associate Professor Department of Dentistry/Noida International Institute of Medical Sciences (NIIMS)/Noida International University (NIU), Greater Noida District Gautam Budh Nagar Uttar Pradesh India.
Dr. Pooja Bhatia Dawar
Consultant Vaani Dental Care, NIT-5, Faridabad-121001.